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AIDS NEWS SERVICE
Michael Howe, MSLS, Editor
AIDS Information Center
VA Medical Center, San Francisco
(415) 221-4810 ext 3305
September 30, 1994
Safer Sex: Information for Counselors
(Part VIII)
References - Condoms
Sex Behavior
(Arranged Chronologically)
AU - Grimley DM. et al.
TI - Assessing the stages of change and decision-making for
contraceptive use for the prevention of pregnancy, sexually
transmitted diseases, and acquired immunodeficiency syndrome.
AB - A synergistic approach was taken to examine contraceptive
use adoption for two related behaviors: pregnancy prevention and
the prevention of sexually transmitted diseases (STDs), including
human immunodeficiency virus (HIV)/acquired immunodeficiency
syndrome (AIDS). One hundred twenty-three young adults responded
to questionnaire items based on two constructs from the
Trans-theoretical Model of Change, the Stages of Change and
Decisional Balance, as well as other pertinent variables. In Phase
1, two Decisional Balance measures were developed: One for the
prevention of pregnancy and one for disease prevention. Final
versions of both measures consisted of two 10-item scales: one
representing the positive aspects (PROS) and one representing the
negative aspects (CONS) of contraceptive and condom use. In Phase
2, the same individuals were staged for both pregnancy and disease
prevention according to their readiness to change for contraceptive
and condom use. MANOVAs and ANOVAs indicated that the PROS and CONS
for both measures were related to stage of change for both
contraceptive and condom use. Results from this pilot study were
consistent with prior applications of the Trans-theoretical Model
to the cessation of such problem behaviors as smoking and to the
adoption of positive health behaviors such as exercise acquisition.
SO - Health Educ Q. 1993 Winter;20(4):455-70.
AU - Sacco WP. et al.
TI - Gender differences in AIDS-relevant condom attitudes and
condom use.
AB - Two studies, conducted approximately one year apart, examined
gender differences in AIDS-relevant condom attitudes, condom use
behaviors, and relationships among attitudes and condom use
behaviors. Subjects (N = 248, N = 528) were undergraduates,
primarily heterosexual. Females reported more favorable attitudes,
with the exception of greater inhibition about buying and
possessing condoms. Men engaged in preliminary condom use behaviors
(carrying and keeping condoms at home) substantially more often
than did women. Preliminary condom use behaviors predicted past and
intended condom use more consistently for men than for women.
Relationships between condom attitudes and condom use behaviors
were generally similar for both sexes, with poorer self-control
explaining the most variance in past and intended condom use. These
results, interpreted from the perspective of Eagly's (1987) gender
role theory, suggest that although females may indirectly influence
condom use decisions, providing condoms is the expected role of
males, infusing them with greater control over the interpersonal
process.
SO - AIDS Educ Prev. 1993 Winter;5(4):311-26.
AU - Wulfert E. et al.
TI - Condom use: a self-efficacy model.
AB - A survey of heterosexually active college students gathered
information about condom use, self-efficacy (SE), outcome
expectancies, sexual attitudes, peer group influences, acquired
immunodeficiency syndrome (AIDS) knowledge, and perceived
vulnerability to AIDS. On the basis of A. Bandura's (1986)
social-cognitive theory, a structural model with SE as the central
mediator was formulated and evaluated with LISREL. This model
explained 46% of the variance in condom use from judgments of SE
and effects attributable to peers and 53% of the variance in SE
from outcome expectancies and peer group influences. Sexual
attitudes, AIDS knowledge, and perceived vulnerability did not
predict condom use. Most students were well-informed about human
immunodeficiency virus (HIV) transmission but reported not feeling
at risk, even though many engaged in risky sexual behavior.
SO - Health Psychol. 1993 Sep;12(5):346-53.
AU - Binson D. et al.
TI - U.S. Young adults have lots of sex, lots of partners, yet
refuse to use condoms: the National AIDS Behavioral Surveys.
AB - OBJECTIVE: To assess prevalence and demographic correlates
of high risk sexual behavior among young heterosexual adults in
the USA. METHODS: The National AIDS Behavioral Surveys (NABS: N =
10,630) is a national probability sample of US residents (response
rate = 70%) and a probability sample of urban residents in 23 major
cities with high AIDS prevalence (High Risk Cities sample: response
rate = 65%). We examined prevalence and demographic correlates of
AIDS-related risk behaviors among young adults. 18 to 25 years of
age, (n = 1,201) in the High Risk Cities (54% white, 24% African
American, 17% Latino American, 5% other ethnic groups). RESULTS:
30% of young adults engaged in risky behavior over the last 12
months and only 20% of these used condoms consistently. 65% engaged
in risky behavior over the last 5 years. The breakdown by risk
factor (behaviors assessed for last year) for men and women at risk
is shown below: TABULAR DATA, SEE ABSTRACT VOLUME. Men, the
unmarried, and those 18 and 19 were the most likely to have
multiple sex partners. Among Whites and African Americans, young
people with education beyond high school were more likely to have
multiple partners than those with less education. Of those with
multiple sex partners, approximately 40% never used condoms with
either primary or secondary partners. As the number of secondary
partners increased, condom use decreased. CONCLUSION: In the US,
prevention proposals targeted at young adults typically tie
protection from AIDS to monogamous commitment. These fail to
capture the realities of young adults and are bound to fail. Even
worse, these messages are misleading because monogamy for young
adults is short-lived.
SO - Int Conf AIDS. 1993 Jun 6-11;9(2):690 (abstract no.
PO-C11-2840).
AU - Friedman SR. et al.
TI - Widespread condom use by seropositive injecting drug users
with non-injector sexual partners.
AB - OBJECTIVE: To assess whether condom use by injecting drug
users (IDUs) differs by HIV serostatus and/or by sex partner (SP)
characteristics. METHODS: 293 street-recruited New York IDUs (69%
male) were HIV tested and asked about their relationships with up
to 10 SPs each. Analyses focus on condom use during the prior 30
days in 386 sexual partnerships. 28 linked pairs of IDUs who are
each others' SPs were compared for data validation. RESULTS: 35%
of respondents were seropositive. 25 of 28 (89%) linked pairs
agreed on the proportion of sex acts in which they used condoms.
Always using condoms is reported in 33% (128/386) of relationships.
The table shows proportions of relationships in which condoms are
always used: TABULAR DATA, SEE ABSTRACT VOLUME. In multivariate
logistic regression controlling for gender, closeness of
relationship, and other variables, condoms are always used more in
relationships between seropositive IDUs and non-IDU SPs than in
other relationships (odds ratio = 4.59; 95% CI = 1.57, 13.41).
CONCLUSIONS: Condom use by IDUs in New York, with its relatively
mature epidemic, is concentrated where it may most reduce the
spread of HIV to non-IDU heterosexuals--in relationships between
infected IDUs and non-IDU partners. This may reflect IDUs' altruism
and/or non-IDU SPs' pressure; prevention projects should build upon
both. Mathematical modelers should incorporate differential condom
use by serostatus and partner's drug use.
SO - Int Conf AIDS. 1993 Jun 6-11;9(2):691 (abstract no.
PO-C11-2847).
AU - Sasse H. et al.
TI - Low level of always condom use with either partners among
bisexual males engaging in penetrative sexual practices with female
and male partners.
AB - OBJECTIVES: To compare, in bisexual males, penetrative sexual
practices (PSP) in 1991 with female partners to PSP with male
partners. METHODS: Participants of this multicenter study,
conducted in public gay meeting places in 17 italian cities during
the period Nov. 1991-Jan. 1992, were homosexual and bisexual males.
Males reporting in 1991 female and male partners were classified
as bisexuals. Always using condoms during PSP was considered
protected behavior and not always or never condom use unprotected
behavior. Data analyses were performed using Epi-info and BMDP
programs. RESULTS: Among the 1227 participants, 451 (37%) men had
had female and male partners during life-time, and 241 (20%) during
1991. Of these 241 bisexuals, 40% were 25 years old or younger, and
either two thirds had had the first sexual contact with male (164,
68%) and female partners (160, 66%) until the age of 20 years. 100
(42%) BI engaged in 1991 at least once a week in male-to-male sex
and 76 (32%) in male-to-female sex (p < 0.05). 75/94 (80%) BI
engaged in PSP with steady male partners, 172/209 (82%) with
non-steady male partners and 173/241 (72%) with female partners.
Among them, proportions of unprotected PSP was lower with
non-steady male partners (73, 42%) than with steady male partners
(56, 75%) and than with female partners (121, 70%) (p = < 0.05).
38/170 (22%) BI engaging in PSP with either female and male
partners reported always using condoms with either partners. There
was low agreement between protected and unprotected PSP with either
partners among BI engaging in PSP with female and with non-steady
male partners (125/170, 74%) (K-statistics: K = 0.22, 95% CI:
0.06-0.38). 38/51 (75%) BI using always condoms with female
partners reported even always using condoms with non-steady male
partners, instead of 38/90 (42%) BI for the opposite condition (p
< 0.05). CONCLUSIONS: One fourth of bisexuals engaging in 1991 in
penetrative sexual practices PSP with female and male partners
reported always using condoms with either partners. Conditions that
favour greater condom use with female partners may have an
important role for HIV prevention.
SO - Int Conf AIDS. 1993 Jun 6-11;9(2):819 (abstract no.
PO-D07-3608).
AU - Oswalt R. et al.
TI - Sex, AIDS, and the use of condoms: a survey of compliance in
college students.
AB - To evaluate compliance with the suggestion that condoms be
used during risky sexual activity, 206 college students' use of
condoms during genital and anal sex was surveyed. Analysis
indicated that 78% engaged in genital intercourse, and while 20%
always used a condom, 44% used condoms less than half the time. Of
the 10% engaged in anal sex, 90% did not use condoms. Students at
highest risk (with the most partners) were using condoms least
often. All respondents reported knowing AIDS was transmitted
sexually. Nonetheless, reasons given for not using condoms were
belief they knew their partners' sexual history or another form of
birth control was being used. Results suggest that outcome studies
are needed to assess programs which focus on behavioral change,
including use of condoms.
SO - Psychol Rep. 1993 Jun;72(3 Pt 1):764-6.
AU - White D. et al.
TI - Sexual issues and condom use among injecting drug users.
AB - Recent surveys of injecting drug users reveal that their
injecting behaviours have changed in the light of HIV, but their
sexual behaviours have not and, in particular, they remain
reluctant to use condoms to reduce the risks of sexual
transmission. In an attempt to explore this issue further the
present study assessed the behaviours and attitudes of injecting
drug users to sexual issues, including condom use. Condom use was
low. Obstacles to their use included for some a desire to conceive,
for many a belief in their infertility, a perceived invulnerability
to HIV infection through their sexual behaviour patterns, a dislike
of condoms and difficulty in negotiating condom use with partners.
The lifestyle of drug users may also have an influence on condom
use. Many drug users funded their habit through illegal activities
including prostitution, theft and fraud. The association between
these and other factors and condom use are explored.
SO - AIDS Care. 1993;5(4):427-37.
AU - McCusker J. et al.
TI - Use of condoms by heterosexually active drug abusers before
and after AIDS education.
AB - This study identified variables associated with increased
condom use among drug abusers in a randomized trial of three AIDS
educational programs in a short-term inpatient detoxification
program. Participants (n = 301) completed baseline and follow-up
interviews and were heterosexually active on both occasions. At
baseline, 10% always, 24% sometimes, and 66% never used condoms,
and this distribution changed only slightly at follow-up. Among
the latter two groups, 21% increased their use. There was no
differential intervention effect on changes in condom use. Women,
but not men, were more likely to initiate condom use than to
increase to consistent use with all partners, and to initiate use
if they had multiple partners. Although beneficial attitudes and
beliefs about condoms were more common among women at baseline,
positive changes in these attitudes/beliefs were associated with
increased condom use among men only. Among men, personal attitudes
and beliefs were associated with increased condom use, while among
women, perceptions of the attitudes of sexual partners were more
important.
SO - Sex Transm Dis. 1993 Mar-Apr;20(2):81-8.
AU - Johnson RL. et al.
TI - Sexual behaviors of African-American male college students
and the risk of HIV infection.
AB - A survey of the rates of sexually transmitted diseases and
protective sexual behaviors among a population of African-American
male college students demonstrates that although monogamy,
avoidance of casual sexual activity, and the avoidance of the use
of drugs and alcohol during sexual activity tends to decrease the
risk of exposure to human immunodeficiency virus, consistent condom
use is the only sexually related behavior that is significantly
protective.
SO - J Natl Med Assoc. 1992 Oct;84(10):864-8.
AU - Martin DJ
TI - Inappropriate lubricant use with condoms by homosexual men.
AB - Use of condoms has been advocated as an important method of
reducing the risk of human immunodeficiency virus (HIV)
transmission among high-risk groups such as homosexual and bisexual
men, prostitutes, intravenous drug users, adolescents, and
hemophiliacs. Despite risk-reduction education campaigns directed
to gay men since the early 1980s, evidence shows continued deficits
in condom-use skills and knowledge among gay men. Because most
failures in the use of condoms are attributed to errors in use,
increasing knowledge and skills in condom use is important in
preventing HIV infection. Two groups of homosexual and bisexual men
were sampled, those entering a risk-reduction education program and
participants in a Gay Pride event. They were surveyed on their
current sex practices and their efforts to reduce their risk of HIV
infection. They were asked about their numbers of sex partners,
specific sexual behaviors, use of condoms, types of condoms used,
and lubricants used for genital-anal sex. The characteristics of
those surveyed were similar to those of respondents in other
studies of risk reduction among gay men. The use of an oil-based
lubricant with condoms has been shown to weaken latex and to
increase the likelihood of condom breakage, which use of
water-based lubricants does not. Among respondents who reported
having genital-anal sex, 60 percent reported use of an oil-based
lubricant with a condom at least once during the year before the
survey. Gay men in sexually exclusive relationships engaged in less
consistent use of condoms for receptive genital-anal sex than did
single gay men.(ABSTRACT TRUNCATED AT 250 WORDS)
SO - Public Health Rep. 1992 Jul-Aug;107(4):468-73.
AU - Gomez CA. et al.
TI - Condom use in U.S. Hispanic men with multiple female
partners.
AB - OBJECTIVE: To describe condom use and its predictors in
Hispanic men with multiple female sexual partners. METHOD: In nine
states of the U.S. with high proportions of Hispanics, a stratified
clustered random telephone sampling strategy was used to identify
Hispanic households. Interviews of 968 Hispanic males, aged 18 to
49 were conducted resulting in 521 (53.8%) men who reported having
one female partner and 371 (38.3%) men with more than one female
partner in the prior 12 months. Frequency of condom use with steady
and causal partners in the 12 months prior to the interview was
measured on a 5-point always-never scale. RESULTS: Among Hispanic
men with multiple female partners, 60% reported always using
condoms with their casual partners while only 18% always used with
their steady partner. Carrying condoms, self-efficacy to use
condoms, positive attitude towards use, having friends who used,
and lack of depression in the two weeks prior to the interview
predicted casual condom use (R2 = .35), whereas drug and alcohol
use before sex did not. Comfort with sex significantly predicted
carrying condoms, attitude toward use, and self-efficacy to use
them. CONCLUSION: High rates of condom use with causal partners
among high risk Hispanic heterosexual men suggest that programs to
promote condom use with casual partners can succeed with this
population. These programs should address the specific skills 1
needed to carry and use a condom with a causal partner, and
increase comfort with sexuality in general.
SO - Int Conf AIDS. 1992 Jul 19-24;8(3):168 (abstract no. PuC
8091).
AU - Catania JA. et al.
TI - Changes in condom use among homosexual men in San Francisco.
AB - Employed data from two longitudinal surveys of gay men in
San Francisco (a) to examine for cohort (Study 1) and attrition
(Studies 1 and 2) bias effects on reported changes in condom use
by gay men and (b) to investigate predictors of condom use (Study
2). Substantial increases in condom use were observed, and these
changes were unrelated to attrition and cohort bias. In terms of
predictors of condom use, men who always used condoms had higher
levels of social support from informal sources of help, had more
positive expectations that condoms would have positive
interpersonal and personal consequences, and were more likely to
be HIV positive than men who used condoms occasionally or never.
The results are discussed in terms of their implications for
HIV-prevention research.
SO - Health Psychol. 1991;10(3):190-9.
AU - Stewart DL. et al.
TI - Attitudes toward condom use and AIDS among patients from an
urban family practice center.
AB - As part of an effort to better educate patients about using
condoms, a survey was done to assess the sexual practices,
attitudes toward acquired immunodeficiency syndrome (AIDS) and
condom use by patients who visit an urban family practice center.
A self-administered questionnaire was given to 126 patients of whom
the majority were black and single. Seventeen percent indicated
they had sex with more than one person in the 3 months before the
survey. Within the last 5 years, 10% had sex with an intravenous
drug abuser, and 6% with someone of the same sex. Fifty percent
believed that condoms decrease sexual pleasure for men and 31%
thought condoms made sex inconvenient. Twenty-seven percent of
those surveyed believed that a man's penis may be too large for a
condom and 18% believed that uncircumcised men could not use
condoms. Forty-five percent believed they should be screened for
human immune deficiency virus exposure. The results highlight
attitudes and beliefs that may function as barriers to condom use
and should be addressed when encouraging condom use with this
population.
SO - J Natl Med Assoc. 1991 Sep;83(9):772-6.
AU - Ku L. et al.
TI - The association of AIDS education with sexual behavior and
condom use for teenage men in the United States.
AB - OBJECTIVE: This paper analyzes the association of the receipt
of AIDS education (formal instruction about AIDS, mostly in
schools) with the number of partners, frequency of intercourse and
condom use for a national sample of teenage men. METHODS: The 1988
National Survey of Adolescent Males conducted in-person interviews
with a nationally representative sample of 1,880 American men 15
to 19 years old. RESULTS: In preliminary multivariate analyses,
those with formal instruction about AIDS report (1) increased
condom use in the last year, (2) decreased in the frequency of
intercourse in the last year (for older youth and those behind in
school), and (3) depending on mode specification, either a
reduction or no significant effect for the number of partners in
the last year. Analyses also explore whether the associations of
AIDS education with behaviors are mediated by differences in
knowledge or attitudes about AIDS. DISCUSSION: The analysis
indicates that AIDS education, as practiced across the U.S., was
associated both with greater condom use and with reduced sexual
activity. However, it cannot demonstrate a causal relationship.
School-based AIDS instruction had no apparent adverse effects with
respect to sexual activity.
SO - Int Conf AIDS. 1991 Jun 16-21;7(2):419 (abstract no.
W.D.4126).
AU - Klee H. et al.
TI - Risk reduction among injecting drug users: changes in the
sharing of injecting equipment and in condom use.
AB - In an investigation of risk behaviour among injecting drug
users in the North-West of England, information was obtained
concerning the sharing of injecting equipment, respondent's sexual
partners and the use of condoms. Between six and nine months after
the initial contact, 169 respondents (56%) were contacted again.
The emphasis in the second phase of the project was on changes, if
any, in risk behaviour that had occurred in the intervening period.
Significant reductions were found in sharing, mostly in the more
indiscriminate use of others' injecting equipment. No reduction was
observed in sharing between injecting partners and little in
sharing between close friends. The number of sexual partners had
decreased and the use of condoms, although it increased among those
involved in temporary relationships, remained low. Impediments to
further progress in risk reduction are discussed.
SO - AIDS Care. 1991;3(1):63-73.
AU - McKusick L. et al.
TI - Tailoring AIDS prevention: differences in behavioral
strategies among heterosexual and gay bar patrons in San Francisco.
AB - Three groups of San Francisco bar patrons (heterosexual men,
heterosexual women, and gay men) were compared on four sexual risk
reduction strategies for AIDS: safer sex practices (particularly
adoption of the use of condoms), reducing the number of sexual
partners, taking the HIV antibody test, and determining the
characteristics of a potential sexual partner. Heterosexuals
reported fewer sex partners and were more likely than gay men to
interview potential partners. Gay men were more likely to use
condoms and the HIV antibody test than their heterosexual
counterparts. These findings encourage the design of interventions
that take advantage of shaping and reinforcing strategies already
in use in each group, and suggest when it is necessary to teach new
strategies.
SO - AIDS Educ Prev. 1991 Spring;3(1):1-9.
AU - Fitzpatrick R. et al.
TI - Factors influencing condom use in a sample of homosexually
active men.
AB - A sample of 502 homosexually active men were recruited from
genitourinary medicine clinics and non clinic sources and
interviewed in relation to their sexual behaviour and factors that
might influence their use of condoms. Three hundred and eighty
three men (76%) reported penetrative anal sex in the previous year.
Ninety four (25%) had not used condoms in penetrative sex. Failure
to use condoms was associated with unfavourable attitudes to them,
not knowing close friends or partners who had HIV-related health
problems, having fewer sexual partners and being in a closed
monogamous relationship. On the other hand levels of awareness
about the risks of unprotected anal sex and involvement in gay
networks and social groups were not predictors of condom use.
SO - Genitourin Med. 1990 Oct;66(5):346-50.
AU - Gallois C. et al.
TI - Preferred strategies for safe sex: relation to past and
actual behaviour among sexually active men and women.
AB - OBJECTIVES: To determine the preferred sexual strategies for
reducing risk of HIV infection among sexually active heterosexual
men and women and homosexual men. To compare these preferences to
past behaviour, intentions and behaviour at the next sexual
encounter, using recent revisions of the Theory of Reasoned Action
as a guide. METHODS: Five groups of sexually active respondents
were examined: 55 male and 78 female heterosexual University
students, aged 17 to 21 years; 85 male (mean age 27.4 years) and
85 female (26.7 years) heterosexuals, and 82 homosexual men (31.2
years), all from the general community. Respondents completed
self-administered questionnaires about their past sexual practices,
their intended practices for the next sexual encounter, their
attitudes and norms about these practices, and their attitudes,
norms, past history, and intentions about variables which increase
or decrease the risk of HIV transmission by sexual means.
Respondents completed and returned a follow-up questionnaire about
their actual behaviour after their next sexual encounter. RESULTS:
The majority of respondents in all five groups stated their
preferred risk-reducing strategy as having sex only in an exclusive
relationship; second choice of all groups was to use a condom.
Respondents were then categorised into one of five strategies: (a)
non-penetrative sex, (b) exclusive relationship plus condom use,
(c) exclusivity without condom use, (d) non-exclusivity with condom
use, (e) non-exclusivity without condom use. Results of ANOVAs and
chi-square tests indicated that all heterosexual groups fell mainly
into categories b and c, while homosexual men fell mainly into a
and d, although minorities in all groups fell into the least safe
category, e. Slippage into a less safe category from intentions to
actual behaviour was less when intentions and past practice were
congruent. Finally, path analyses indicated that past behaviour and
intentions interacted to predict actual behaviour regarding condom
use for all five groups. CONCLUSIONS: The sexual strategies of
heterosexual men and women in terms of risk of HIV transmission are
somewhat different from those of homosexual men, even though all
groups state similar ideal strategies. Past behaviour is a strong
predictor of actual sexual behaviour, because it acts to stabilise
or weaken behavioural intentions. Past behaviour may also influence
the extent to which resources for carrying out preferred strategies
are available. These results have implications for the use of the
Theory of Reasoned Action to predict sexual behaviour, as well as
for safe sex education programmes aimed at heterosexuals and
homosexuals.
SO - Int Conf AIDS. 1990 Jun 20-23;6(1):147 (abstract no.
Th.D.54).
AU - Rossi L. et al.
TI - Changes in the sexual behavior of HIV infected patients
participating in a group process.
AB - OBJECTIVE: To induce changes in the sexual behavior and use
of condom as a preventive measure for diminishing HIV sexual
transmission in a group of HIV seropositive homosexual men.
METHODOLOGY: 36 seropositive, homosexual, asymptomatic, unmarried
men, aged between 18 and 45 years old, requesting psychological
support, were selected. The individuals were assigned to 3 groups:
A (3 months), B (6 months), C (1 year), (90' session, 1 x wk).
Several psychoanalytic group techniques, such as interpretation and
free association, were used. Killing fantasies, incapability to
establish total object relations, hostile feelings towards
homosexuality, uncertainty of presenting clinical symptomatology
and dying were interpreted in group sessions with the purpose of
promoting condom use and modifying risky practices. Changes were
evaluated at the end of all sessions. RESULTS: The results are
presented in the following table: TABULAR DATA, SEE ABSTRACT
VOLUME. DISCUSSION: 3 and 6 months groups were associated with
changes in sexual behavior, the one year's group structural changes
and in the condom's use.
SO - Int Conf AIDS. 1989 Jun 4-9;5:773 (abstract no. Th.D.P.88).
AU - Golombok S. et al.
TI - Condom use among homosexual men.
AB - A postal questionnaire survey of 262 homosexual men was
carried out to investigate patterns of sexual behaviour and the
use of condoms. Two hundred and twenty-nine of these subjects had
been sexually active during the past year, with the mean number of
male sexual partners being 8.09. One hundred and eighty men engaged
in oral sex, and 117 ejaculated during this activity, of whom 103
(88%) did not use a condom. One hundred and sixteen men had engaged
in insertive anal intercourse in the past year, and 102 had
ejaculated during this activity. Of these, 32 did not use a condom.
Some, however, only engaged in this activity within a monogamous
relationship. The overall proportion of men who continued to engage
in very high-risk sexual activity was small, however a different
picture emerged if the sample was analysed in terms of the number
of encounters with different men during the past year. Of the total
estimated number of such encounters, almost half involved anal
intercourse, and about half of these were unprotected. The reason
for the apparent discrepancy is that those who continue to engage
in high risk behaviour tend to be particularly sexually active.
SO - AIDS Care. 1989;1(1):27-33.
AU - Valdiserri RO. et al.
TI - Variables influencing condom use in a cohort of gay and
bisexual men.
AB - Nine hundred fifty-five of 1,384 (69 per cent) gay and
bisexual men enrolled in a prospective study of the natural history
of human immunodeficiency virus (HIV) infection who reported
engaging in anal intercourse in the past six months were surveyed
about condom use practices for both insertive (IAI) and receptive
anal intercourse (RAI). The following results were obtained: 23 per
cent of the men reported that they always used condoms for IAI and
21 per cent for RAI; 32 per cent sometimes used condoms for IAI;
28 per cent sometimes used condoms for RAI; 45 per cent never used
condoms for IAI; and 50 per cent never used condoms for RAI.
Multiple logistic regression analysis revealed that the following
variables were associated with both insertive and receptive condom
use: condom acceptability; a history of multiple and/or anonymous
partners in the past six months, and the number of partners with
whom one is high (drugs/alcohol) during sex. Knowledge of positive
HIV serostatus was more strongly associated with receptive than
with insertive use. Condom use is a relatively complex
health-related behavior, and condom promotion programs should not
limit themselves to stressing the dangers of unprotected
intercourse.
SO - Am J Public Health. 1988 Jul;78(7):801-5.